Caring for ulcerating tumors

SN : We have implemented a special surveillance would-care protocol for our patient, as you know, since she has developed a moderately ulcerating, non-exudative wound.

GN : How is that ?

SN : After assessment in onco-geriatrics, we have decided to put her under oral chemotherapy, with a new wound-healing process.

GN : And what does this consist in ? I mean : is it that different from the usual wound care ? That is in the sense of any chronic wound, we’ll have to clean the patient’s with soap and water first, I guess.

SN : That’s it, for a start. But then we advise using clamps to remove the crusts on and around the wound, that might cause some uneasiness during care.

GN : And for this, I suppose, we can apply some petroleum jelly in order to soften the crusts.

SN : Yes, generally about 15 minutes before care is provided. However, the petroleum jelly should be cleaned after care as there might be a possibility of maceration.

GN : So, as with chronic wounds, we should cover it with all-in-one foam dressing, micro-non-adhesive dressing with no adhesive borders to be as less traumatic as possible on the fragile skin.

SN : And we reiterate the procedure every day if need be, or adapt it to the toileting needs of the patient.

GN : That’s all ?

SN : Not exactly. A remote monitoring and follow-up are implemented by the specialized wound-healing team, with home-based interventions by significant others and private-practice nurses, based on phone exchange and transmission of pictures of the wound. And since oral chemotherapy has favored the stabilization of the cancer, the wound-care protocol will be maintained, as it is well-tolerated and participate in improving the patient’s quality of life, with the objective being to keep the wound clean and manage the resurgence of possible associated symptoms, like pain, bleeding or unpleasant odor form the wound.

GN : However, having an ulcerating tumor can have emotional and physical effects. Is there any procedure that’s advised in this sense ?

SN : Cancer patients, all the more if it’s breast-cancer in women, might feel fear, anger, repulsion towards body image, low self-esteem or even denial. Some patients might worry about how their wound will affect their relationships with family and friends. Others could have worries about how the smell or the appearance of the wound will affect them, especially if there are children in the family. Or they may have worries about being rejected, and therefore avoid social gatherings or physical contact, including sexual relationships. These feelings are not uncommon. Therefore, we recommend talking to close friends and family or having counselling, which can help, like a cancer support group. We can even ask an occupational therapist to implement meaningful activities, such as sewing in order to teach them a satisfying activity and help them make their own top clothing adapted to their condition.